In addition, fewer consensus recommendations are available on the management of osteoporosis in young women than for its treatment in menopausal women.
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In this article, 3 different kinds of cases of bone loss in young women are used to develop key clinical points. A year-old woman has a 3-year history of severe, disabling dysmenorrhea. For 2 years she was treated with nonsteroidal anti-inflammatory drugs and cyclic estrogen-progestin contraceptives before switching to continuous oral contraceptives. These interventions did not relieve her pain. When she was 18, laparoscopy revealed stage I endometriosis, which was resected, providing 6 months of relief. When her pain recurred, the patient was started on leuprolide acetate depot, which caused amenorrhea and provided excellent pain relief.
After 6 months of leuprolide therapy, a DXA bone scan demonstrated osteoporosis with a lumbar spine Z score of—2. The diagnosis of osteoporosis in very young women is complex and continues to evolve. Physicians have been educated to use the T score comparison to the mean peak bone mass of young adults to assess BMD in menopausal women, in whom a decrease in T score of 1 standard deviation is associated with a 2- to 4-fold increase in fracture risk. However, teenage women are often still gaining bone mineral mass as the skeleton develops, so their T scores are normally below that of the peak bone mass of an adult woman.
The Z score gives a good comparison of their bone mass with that of teens of the same sex at a similar developmental stage.
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Most experts agree that, when using DXA test results to assess bone density in women younger than 25, the Z score should be used. The Z score compares the patient with persons of the same age and sex. Do not get enough physical activity. Women of all ages need to get regular weight-bearing physical activity, such as walking, dancing, or playing tennis, to help build and maintain bone density. Have not gotten your menstrual period for three months in a row called amenorrhea. If you have amenorrhea and you are not pregnant, breastfeeding, or taking a medicine that stops your periods, talk to your doctor or nurse.
Not getting your period means your ovaries may have stopped making estrogen. Have an eating disorder.
Eating disorders, especially anorexia nervosa and bulimia nervosa , can weaken your bones. Anorexia can also lead to amenorrhea. Women who smoke have lower bone density and often go through menopause earlier than nonsmokers. Drink too much alcohol. For women, experts recommend no more than one alcoholic drink a day if you choose to drink alcohol.
What are the symptoms of osteoporosis? If this happens, you may get any or all of these symptoms: Sloping shoulders Curve in the back Height loss Back pain Hunched posture. What causes osteoporosis? How is osteoporosis diagnosed? Do I need to be tested for osteoporosis? Your doctor may suggest a bone density test for osteoporosis if: 15 You are 65 or older You are younger than 65 and have risk factors for osteoporosis. Ask your doctor or nurse whether you need a bone density test before age How can I get free or low-cost osteoporosis screening tests? If you have insurance, check with your insurance provider to find out what's included in your plan.
If you have Medicare, find out about Medicare coverage for bone density tests. If you have Medicaid, the benefits covered are different in each state, but certain benefits must be covered. Check with your state's Medicaid program to find out what's covered. If you don't have insurance, you may be able to get a no-cost or low-cost bone density test. To see whether you are eligible for low-cost or no-cost health insurance, visit HealthCare.
How is osteoporosis treated? The most common types of medicine to prevent or treat osteoporosis include: Bisphosphonates. Bisphosphonates help treat bone loss.
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They may also help build bone mass. Selective estrogen receptor modulators SERMs. SERMs may help slow the rate of bone loss after menopause. This injectable drug may help reduce bone loss and improve bone strength if you are past menopause and at higher risk for broken bones from osteoporosis. Calcitonin is a hormone made by your thyroid gland that helps regulate calcium levels in your body and build bone mass.
Taking calcitonin can help slow the rate of bone loss. Menopausal hormone therapy. Often used to treat menopausal symptoms, menopausal hormone therapy may also help prevent bone loss. The Food and Drug Administration recommends taking menopausal hormone therapy at the lowest dose that works for your menopause symptoms for the shortest time needed. Parathyroid hormone or teriparatide. Teriparatide is an injectable form of human parathyroid hormone.
It helps the body build up new bone faster than the old bone is broken down. Your doctor may also suggest getting more calcium, vitamin D, and physical activity. How can I prevent osteoporosis?
Osteoporosis - Better Health Channel
Get enough calcium and vitamin D each day. Get active. Choose weight-bearing physical activities like running or dancing to build and strengthen your bones. Don't smoke.
Smoking raises your risk for broken bones. If you drink alcohol, drink in moderation for women, this is one drink a day at most. Too much alcohol can harm your bones. Also, too much at one time or mixed with certain medicines can affect your balance and lead to falls. Talk to your doctor about whether you need medicine to prevent bone loss. How does calcium help prevent osteoporosis? How much calcium do women need each day? How much calcium you need depends on your age: 16 9—18 years: 1, mg per day 19—50 years: 1, mg per day 51 and older: 1, mg per day Pregnant or nursing women need the same amount of calcium as other women of the same age.
What foods contain calcium? What should I look for when buying food with calcium? Learn how to read food labels on a package. What if dairy foods make me sick or I don't like to eat them? How can I get enough calcium?